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HomeMy WebLinkAbout4-11-40Certificate No. 2234 CITY I SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Rita Busuttil 664 Gossamer Wing Way, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 11, Lot 40 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 11th day of September, 2009. CITY F ASTIAN, FLORIDA ATT T: % ti AI Minner Sally/A. Maio, MMC City Manager City Clerk Name Y '+ Unit Block Lot Date of Mark -out �` q / O f' Date of Burial / �� �© Time Name of Funeral Home ,r-- outhnri7atl by CO CO W �WW � 0 Q d w t Y V � j CO Q v F • ii 0 Busuttil, Paul Francis Paul Francis Busuttil, 76, died Sept. 8, 2009, at Sebastian River Medical Center in Roseland. He was born in Malta and lived in Sebastian for one year, coming from Cooper City. Before retirement, he was an executive chef at the Sonesta Beach Hotel in Key Biscayne and at the Key Biscayne Hotel and Villas, where he frequently cooked for former President Richard Nixon. He served in the Army during the Korean War. He was a member of St. Sebastian Catholic Church in Sebastian. He was a member of the American Legion, American Culinary Federation and Chaine de Rotissier and was voted Chef of the Decade in the 1980s by the ACF. Survivors include his wife of 48 years, Rita Busuttil of Sebastian; sons, Ernest Busuttil of Asheville, N.C., Paul Francis Busuttil Jr. of Germany, Frank Busuttil of Wayne, N.J., John "Butchie" Busuttil of Northburg, N.J., and Joseph Busuttil of Middleburg; daughters, Catherine "Trina" Taylor of Atlanta and JoAnne Martucci of Wringwood, N.J.; sister, Teresa Maragoudakis of Detroit; 10 grandchildren; and one great - grandchild. SERVICES: Visitation will be from 5 to 7 p.m. Sept. 10 at the Strunk Funeral Home in Sebastian. Military honors conducted by the Sebastian Area Veterans' Honor Guard will follow at 7 p.m., in the funeral home chapel. A Mass of Christian burial will be celebrated at 9:30 a.m. Sept. 11 at St. Sebastian Catholic Church. in Sebastian. Burial will follow in Sebastian Cemetery in Sebastian. Published in the TC Palm on 9/10/2009 FLORIDA DEPAREf HEA A. (TYPE) 1. Name of First Deceased State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT Middle Paul Francis 2. Place of Death City, Town or Location County Indian River Sel 3. Name of Medical Certifier Talib Hussain, M. nMedical Examiner 4 4. Name of Funeral Home /Direct Disposal Establishment Last Date Month Day Year of Busuttil Death Sept. $ 2009 Name of (if neither, give street address) Hosp. or Inst. S Phone Number 7768 Bay Street Addres 623 N. Central Ave. 772 - 589 -7177 Fla. Lic. No. /Reg. No. I Phone No. (Area Code) itrunk Funeral Home & Crematory Sebastian, FL I 1228 I 772- 589 -1000 5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b• Colleen was contacted on 918/09 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Hussain will complete and sign the medical certification of cause of death within 72 hours. C. was contacted on He /she verified that Medical Examiner, will complete and sign the me *al al rti cati ojxWse gfodeath within 72 hours. 6. Funeral Director/ na a F.E. No. /Reg. No. Date Signed DweeHNaposer 44048 9/8/09 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228- 09-0406 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. [:]No extension of time for filing the death certificate has been requested. Regiek9e We Date Date Certificate Subregistrar Signature CAA2144 Issued: 9/8109 Dye: 9 /13/09 C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL- AT-SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral Director /Direct Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery BURIAL FiSTORAGE Date of Disposition W /! /�. CREMATION Signature of Sexton or Person -in- Charge OTHER (Specify) J This permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. Distribution: white: Cemetery or Crematory DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740- 000 -0326 -2) Pink: Local Registrar X-7dw I&I Ar- MY Of SIERASTLAN ROME OF s I City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. P_ I' fQ Hain ft-i C Name(s) &(024 6D5.S me.r W iha GcJau. 52hQSfi'an �� 32g58 r_Tr:1=1 Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: 4&,I�ard o4q,5( X%0_0 Dollars ($ 1606. 1).0 1 on this_ 1 t '_" day of 0 , 20D _(� for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit. Block , Lots) Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. Additional Fees paid at time of purchase: Corner Markers (set of 4 = $20) Opening & Closing /50.00 / W O H Circle One Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser I: \W W- DATAWIs- Cemetery\RECEIPT. doc Interment Disinterment . TOTAL $ 0 U ieyo f S ebastian The following documents were provided as Proof of Residency: and Sep 26 2008 2.:45PM HP LRSERJET 3200 p•1 FUNERAL DIRECT R'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBASTtgN hOW C1 PILKAwAAND For infor matlor. contact: KiP Kelso - Cemefery Sexton Sebastian Mtjnlcfpaf Cemetery r (772) 589 -2545 City Clerk's Office City Halt, 1225 Main Qlrest 1 Sebastian, FL 32958 Offict (772) 388 -8215 or 388 -8214 Fag: (772) 589.5570 FUNERAL HOME: ADDRESS: PHONE #: 1L No. CW tralAve. (Check One) ' X OPEN BURIAL LOT LI l Block 11 Unit 40 _OPEN CREMAINS LOT L t._., B)Ock Unit ._._.OPEN COLUMBARIUM NICHE N che Block' Unit BURIAL DATE AND SERVICE TIME: 19/11/09 9:30 a. m. �~ FOR DECEASED: Paul F rvame NAME AND-SIGNATURE OF LOT OW (P,.�t provide proper documentation of Name I certify Vial. I have detennined the owns administrative fees have been paid and ER OR REPRESENTATIVE: wnership) Signa re Date Ship of the abode described site that all site fees and authorize opening of sam4! NAME-AND SIGNAT�PE OF LIgENSE� FUNERALD Name ....................................... - Cemetery Sexton Certification • ... 1 certify that I have checked the ownersr with 2s office an7t I fees have � Q. Cenietgfy Sep a6- This form. to be provided to Clerk's Off information bar viewing the owner's deed and confirming en paid O• Date by Sexton for permanert record upon completion. Oct 03 11 09:16a jimyoung 772 -465 -7949 P.1 reb 13' 2009 11:45FIM COS CEMETERY 7722289927 p.2 bus 0 -rT 1 Am • • • - Stlb�lanfiern� Pb. N 1.4772) M - 2545 11nte : T. NA 11u•Jiip1'ttst�geit< A+4"1 !� r rd1 M Nobs: `(1 �, :�l1gR. , p�• aN!aMi : �t SebtigJi� Cesaie'lei�y.. 'J�Asi'�aer`if'w hder��;Tl, •fiat's d'ry' ..mlx (X) Maikei^i�.C�)'n;eet a Poured foundation. P.,Jeaee f ::x�: -,r�' - Dry MK '•'JWNW& CAVOallv.L • Fgi�pdaf�un �uursd Aaeswn ;. by; . Ea . - ::eoncfnt�s�i1�4 • �-- by /Clh Ok Lot c. ..,w.' �: _ •- i GG7 ; 4 WmCkld. By : , .4i:s ' iC �� 2 Pr 54 rig Oct 0311 09:16a jim young 772- 465 -7949 p.2 _ i \i ,V- W, T. r w Full 04 Hwy i 0 ONE M00-11 lw 0 N 0 0 L. Certificate No. 2215 CITY OF SEB Certificate of Int , t Rig IN ACCORDANCE with provisions ofl Sebastian, it is hereby certified that: In and for cons rights in the Seb ances c Me City of 0.00 is entitled to full interment )r the following lots: 39 & 40 astian Municipal Cemetery, file in the records of the City Clerk for use in accordance a conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 25th day of April, 2009. CITY QF SEJ4ASTIAN, FLORIDA AI Minner City Manager ATTEST: Sally A. aio, MMC City Clerk City of Sebovian Sebastian Cemetery Ph. # 1(772) 589 - 2545 F'ax # 1(772) 228 - 9927 Vole : This is for Informational purposes reguarding Monuments at Sebastian Cemetery . !Mute : This is for Single Markers under 2 ft. S over 2 ft.( over 2 ft. is a poured foundation ) Please return to City of Sebastian U17/ MIX Sebastian Cemetery `°--- 1921 %orlh Cenlral Ave. Foundation poured 32958 BY Attention Cemetery Sexton date %tone installed by : ben Size 1 -0 x 2 -0 x 0 -4 grey granite flat grass vet. marker date : 4/22/10 Name & Date HIS: Paul F.Busuttil D.O.B. 1932 HER: D.O.B. D.O.D. 2009 I D.O.D. Legal Descripition : Unit . 4 Blk . 11 Lot 40 Square Ft. Approved By : K, G. K. Checked By : K . G . K . DATE By strunk , a.b.c. vaults , Example : 4" Imo_